• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.54-64
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• 2021

Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68±2.32 kg/㎡), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO2peak), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion: HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.

• Preventive Nutrition and Food Science
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• v.21 no.1
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• pp.14-23
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• 2016

Non-alcoholic fatty liver disease (NAFLD) is caused by fat accumulation and is associated with oxidative stress. In this study, we investigated the potential protective effect of pomegranate (Punica granatum L.) peel extract (PPE) against oxidative stress in the liver of rats with NAFLD. Sprague-Dawley rats were fed a high fat diet (HFD), 20% corn oil, or palm oil for 8 weeks in the presence or absence of PPE. The control group was fed a basal diet. The progression of NAFLD was evaluated histologically and by measuring liver enzymes (alanine transaminase and aspartate transaminase), serum lipids (triglycerides and total cholesterol), and oxidative stress markers. The HFD feeding increased the body weight and caused NAFLD, liver steatosis, hyperlipidemia, oxidative stress, and elevated liver enzymes. Administration of PPE ameliorated the hepatic morphology, reduced body weight, improved liver enzymes, and inhibited lipogenesis. Furthermore, PPE enhanced the cellular redox status in the liver tissue of rats with NAFLD. Our findings suggest that PPE could improve HFD-induced NAFLD via abolishment of hepatic oxidative damage and hyperlipidemia. PPE might be considered as a potential lead material in the treatment of NAFLD and obesity through the modulation of lipid metabolism.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.168-174
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• 2015

Purpose: Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children. Methods: Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant. Results: Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group ($4.4{\pm}0.42mmoL/L$ vs. $4.8{\pm}0.21$, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR, 0.24; 95% CI, 0.11-0.54; p<0.001). Conclusion: Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.726-732
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• 2016

Objective: To report the clinical effect of Korean medicine treatment in an adolescent patient diagnosed with nonalcoholic fatty liver disease (NAFLD) with obesity. Methods: The patient was treated from July 9th, 2014 to August 7th, 2014. He was taking Saenggangeonbi-tang (生肝建脾湯) during the treatment period. He also undertook regular exercise and regulated his diet to reduce body weight. Results: The patient’s AST, ALT, and GGT levels were significantly decreased. Total cholesterol, triglyceride, and LDL levels were also decreased, and HDL level was increased. His body weight and body mass index (BMI) were decreased. Conclusions: The results suggest that Saenggangeonbi-tang with exercise and regulated diet could be an effective treatment for adolescent NAFLD with obesity in clinics.

• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.30-35
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• 2019

Purpose: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. Methods: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10-18 years of age. Body mass index ${\geq}95th$ percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. Results: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10-17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level <40 mg/dL (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.13-7.10; P=0.048), total cholesterol level >200 mg/dL (HR, 5.6; 95% CI, 1.23-15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22-4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. Conclusion: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.3
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• pp.233-241
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• 2019

Purpose: Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. Methods: The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008-2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. Results: Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07-2.95) after adjusting for age, gender, obesity, and metabolic syndrome. Conclusion: Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.

• Journal of the Korean Society of Food Culture
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• v.38 no.4
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• pp.270-282
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• 2023

We performed a study to examine the association between diet quality and nonalcoholic fatty liver disease (NAFLD). Our study included 3,586 women aged 40-64 years who participated in the sixth Korea National Health and Nutrition Examination Survey. The study subjects were classified into the NAFLD group (n=816) and the normal group (n=2,770) using the hepatic steatosis index. The anthropometric indices, blood profiles, and dietary intake data of the subjects were obtained. The waist circumference, body mass index, and the serum levels of triglycerides, fasting blood sugar, HbA1c, and systolic and diastolic blood pressures were higher in the NAFLD compared to the normal groups (p<0.001, respectively). The intakes of protein (g/kg body weight, p<0.001), potassium (p<0.001), and vitamin A (p=0.006) were significantly lower in the NAFLD group. It was observed that the higher the total Korean Healthy Eating Index score, the lower the risk of NAFLD. A reverse relationship was shown between the NAFLD risk and the intakes of total fruits, total vegetables, vegetables excluding Kimchi and pickled vegetables, meat, fish, eggs and beans. Therefore, it is recommended that middle-aged women in Korea increase their intakes of fruits, vegetables, and foods high in protein for the proper management of NAFLD.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.95-103
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• 2006

Purpose: With remarkable increase in the prevalence of childhood obesity, nonalcoholic fatty liver disease increased, The aim of this study is to evaluate the prevalence of the increase liver enzymes, lipid levels and fasting blood glucose level in normal and obese children. Methods: A total of 2206 elementary students were grouped according to obesity index; normal group and obesity group(mild, moderate, severe). Aspartate aminotransferase(AST, SGOT) and alanine aminotrausferase(ALT, SGPT) were measured with tota1 cholesterol, triglyceride and fasting blood glucose. Results: Compared with the 2.7% of ALT > 50 IU/L in normal group, obese groups showed significantly higher prevalence; 6.7% in mild obesity group, 11.8% in moderate group and 15.0% in severe group. The prevalence of hypertriglyceremia was 12,4% in normal weight group, which is significantly lower than obesity group(mild obesity group 24.8%, moderate and severe 32.1% each). Conclusion: The prevalence of nonalcoholic fatty liver increased along with severity of obesity. Of Nutritional assessment, intervention, and preferably prevention are necessary for health promotion elementary students.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.431-443
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• 2021

BACKGROUND/OBJECTIVES: Nobiletin (NOB), a citrus flavonoid, is reported to have beneficial effects on cardiovascular and metabolic health. However, there is limited research investigating the effect of long-term supplementation with low-dose NOB on high-cholesterol diet (HCD)-induced hypercholesterolemia and non-obese nonalcoholic fatty liver disease (NAFLD). Therefore, we investigated the influence of NOB on hypercholesterolemia and NAFLD in HCD-fed mice. SUBJECTS/METHODS: C57BL/6J mice were fed a normal diet (ND) or HCD (35 kcal% fat, 1.25% cholesterol, 0.5% cholic acid) with or without NOB (0.02%) for 20 weeks. RESULTS: HCD feeding markedly reduced the final body weight compared to ND feeding, with no apparent energy intake differences. NOB supplementation suppressed HCD-induced weight loss without altering energy intake. Moreover, NOB significantly decreased the total cholesterol (TC) levels and the low-density lipoprotein (LDL)/very-LDL-cholesterol to TC ratio, and increased the high-density lipoprotein-cholesterol/TC ratio in plasma, compared to those for HCD feeding alone. The plasma levels of inflammatory and atherosclerosis markers (C-reactive protein, oxidized LDL, interleukin [IL]-1β, IL-6, and plasminogen activator inhibitor-1) were significantly lower, whereas those of anti-atherogenic adiponectin and paraoxonase were higher in the NOB-supplemented group than in the HCD control group. Furthermore, NOB significantly decreased liver weight, hepatic cholesterol and triglyceride contents, and lipid droplet accumulation by inhibiting messenger RNA expression of hepatic genes and activity levels of cholesterol synthesis-, esterification-, and fatty acid synthesis-associated enzymes, concomitantly enhancing fatty acid oxidation-related gene expression and enzyme activities. Dietary NOB supplementation may protect against hypercholesterolemia and NAFLD via regulation of hepatic lipid metabolism in HCD-fed mice; these effects are associated with the amelioration of inflammation and reductions in the levels of atherosclerosis-associated cardiovascular markers. CONCLUSIONS: The present study suggests that NOB may serve as a potential therapeutic agent for the treatment of HCD-induced hypercholesterolemia and NAFLD.

• The Korea Journal of Herbology
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• v.29 no.2
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• pp.47-54
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• 2014

Objectives : This study was undertaken to verify the effect of Gangjihwan(Di-fatty, DF) composed with Pakistani Ephedra Herba on nonalcoholic fatty liver disease(NAFLD) using high fat diet-fed male mice. Method : Eight-week old C57BL/6N mice were used for all experiments. Standard chow diet-fed mice were used as normal group and high fat diet-fed NAFLD mice were randomly divided into 5 groups: control, atorvastatin, DF(1), DF(2) and DF(3). After 8 weeks, mice were treated with water, atorvastatin(10mg/kg) and DF(40, 80, 160mg/kg) for 8 weeks. And we investigated body weight gain, plasma lipid and glucose metabolism, histological analysis for liver on the mice. Results : Compared with controls, DF-treated mice had very significantly lower body weight gain and lower visceral adipose tissue weight, the magnitudes of which were prominent in DF(3). Consistent with their effects on body weight gain, DF-treated mice had lower blood total cholesterol and triglyceride level compared with controls. Consistent with their effects on body weight gain and blood plasma lipid level, DF-treated mice had lower liver weight and hepatic lipid accumulation of DF-treated groups was significantly decreased than control group. Also Blood plasma AST, ALT and ${\gamma}$-GT concentration were not changed by DF, and these results may indicate DF do not show any toxic effects. Conclusions : These results suggest that DF effectively improves NAFLD. DF reduces liver weight and prevents lipid accumulation of hepatocyte by reducing body weight gain and modulating blood plasma lipid metabolism levels.